The change over time in the prescription pattern of the first targeted drug after failure of conventional therapy in patients with rheumatoid arthritis: a 20-year real-world experience
Authors' conclusion
The expansion of the therapeutic armamentarium has changed the management strategy of RA over time towards an earlier introduction of targeted drugs (increasingly often as monotherapy) in patients with progressive lower disease activity and a history of failure with fewer previous conventional drugs.
Study context
- Population
- Rheumatoid arthritis (RA) patients in an Italian single-centre registry who received their first b/tsDMARD between October 1999 and December 2022
- Participants
- 1,206 patients
- Exposure
- Patients stratified by period of first b/tsDMARD initiation: 1999-2004, 2005-2010, 2011-2016, 2017-2022
- Outcome
- Change over time in the pattern of first b/tsDMARD prescription and baseline characteristics
Methodological detailssingle-centre registry, Italian
- Single-centre registry
- Italian
Main finding
As reported in the abstract
- Disease duration, years (1999-2004, 2005-2010, 2011-2016, 2017-2022)
- 12.26, 10.5, 9.7, 8.1; p<0.0001
- Mean number of conventional DMARDs before first b/tsDMARD
- 3, 2.5, 2.1, 1.4; p<0.0001
- Mean clinical disease activity index (CDAI) score
- 30.1, 24.3, 21.8, 20.4; p<0.0001
- First-line TNF-α inhibitor prescription, progressive reduction (% of patients)
- from 95 to 43%
- b/tsDMARD monotherapy, progressive increase, especially among those not receiving a TNFα inhibitor
- from 18 to 26%
Observational data: associations, not effects.
Original publication
The change over time in the prescription pattern of the first targeted drug after failure of conventional therapy in patients with rheumatoid arthritis: a 20-year real-world experience. Clin Exp Rheumatol. Published 28 December 2023. doi:10.
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